上海浦兴社区老年人高血压与体质指数、腰围、颈围相关性及性别差异

Gender specific associations of body mass index,waist circumference,and neck circumference with hypertension in a Shanghai elderly population

目的在社区自然人群中探讨不同性别的老年人体质指数(BMI)、腰围、颈围与高血压的相关性及其对血压均值及高血压患病的影响。方法采用整群抽样的方法,对上海浦东新区浦兴社区11个居委会65岁以上老人进行横断面调查。采用Excel建立数据库,SPSS17.0统计软件对性别分层的高血压相关危险因素分别进行多因素分析,进一步以女性颈围四分位分组,分析其对血压的影响。结果共调查2092人,男性971人(46.4%),女性1121人(53.6%)。无论男女,高血压组的BMI、腰围、颈围均高于非高血压组(P<0.001);全身性肥胖、腹型肥胖、颈围超标在高血压组所占比例高,与非高血压组差异有统计学意义(P<0.001)。多因素Logistic回归分析在校正一般危险因素后显示,三种肥胖类型均与高血压显著相关;进一步进行三种肥胖指标两两互相校正显示:只有女性高血压风险与颈围超标显著相关,OR及95%CI在调整BMI后为1.44(1.03~2.01)(P=0.032);调整腰围后为1.56(1.12~2.18)(P=0.009)。根据女性颈围四分位分组进行分析,收缩压、舒张压、高血压患病率随着女性颈围的增加而增加,以颈围<32.5 cm为对照,颈围≥36 cm组患病危险OR为2.21(95%CI 1.51~3.24,P<0.001)。结论该老年人群中,校正一般因素后,三种肥胖指标均与高血压相关。在老年女性中,颈围独立于其他两种肥胖指标与高血压显著相关。

Aim To investigate the associations of body mass index(BMI),waist circumference(WC),and neck circumference(NC)with hypertension in elderly men and women.Methods The study performed a cross-sectional survey by cluster sampling among the elderly of 65 years or older in 11 residential committees of Puxing Community,Pudong New District,Shanghai.The Excel software was used to construct a database,and the SPSS statistical software(Version 17.0)for univariate and multivariate analysis.It also performed analysis on blood pressure across the quartile distributions of neck circumference in women.Results A total of 2092 subjects included 971 men(46.4%)and 1121 women(53.6%).BMI,waist circumference and neck circumference were higher in hypertensive subjects than normotensive subjects both men and women(P<0.001).The proportions of general obesity,abdominal obesity and greater neck circumference were significantly higher in hypertensive subjects than in normotensive subjects(P<0.001).In multivariate Logistic regression analysis with adjustment for other covariables,all three obesity indices were associated with hypertension.With mutually adjustment for other obesity indices,only greater neck circumference was significantly associated with hypertension in elderly women(OR 1.44,95%CI 1.03~2.01,P=0.032)for additional adjustment with BMI,and(OR 1.56,95%CI 1.12~2.18,P=0.009)for additional adjustment with waist circumference.The level of systolic and diastolic blood pressures and the prevalence of hypertension increased with the quartile distributions of neck circumference in elderly women.The risk of hypertension was significantly higher in those with the neck circumference≥36 cm compared with those whose neck circumference<32.5 cm(OR 2.21,95%CI 1.51~3.24,P<0.001).ConclusionsIn this elderly population,all three obesity indices was associated with hypertension.The neck circumference was associated with hypertension independently of other two obesity indices in elderly women.